While I am thrilled to see the majority of the committee take a dramatic turn for the better, I thought that it might help to see an example of what Dr. Fillingim has been working on (126 articles on pain, one of which was on fibro in 2003, 13 on TMJ, 4 recent articles on IBS).

The idea is if you are a chronic-pain patient and your spouse babies you, essentially you are being rewarded for being in pain. And the more reinforcement you get for engaging in pain behaviors, the more pain behaviors you will show, Fillingim said.

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I can't believe they fund this ^(*^(!. :headache::headache::headache::headache::headache: I wonder how much money they spent on that study!

The idea is if you are a chronic-pain patient and your spouse babies you, essentially you are being rewarded for being in pain. And the more reinforcement you get for engaging in pain behaviors, the more pain behaviors you will show, Fillingim said.

I can't believe they fund this ^(*^(!. :headache::headache::headache::headache::headache: I wonder how much money they spent on that study!

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As I said, I have worked in a pain clinic and movement for many pain patients eventually leads to a dramatic reduction in pain (often referred to as myofacial pain - muscles shorten and reduce range of motion, trigger points, etc.). My problem is that just as the healthy population benefits from exercise, so does a large segment of the pain patient population. Lacking experience in CFS or an appreciation of PEM, Dr. Fillingim has no experience with or appreciation of the processes involved in CFS (he is quite likely to think that he does if he makes unwarranted assumptions about non-existant similarities between CFS and pain patients). Dr. Fillingim's one and only fibro article (2003) simply concludes that using a number of self-report measures, he identified "biopsychosocial" components to pain in fibro pateints but that there appeared to be additional pathophysiological components he didn't understand.

There used to be a famous psychologist called Dr Dement. Sure there must be some other good ones about.

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I'm sure Bill Dement, (William C. Dement, MD, Ph.D.), famous sleep researcher (trained as a psychiatrist with PhD in neurophysiology) would be surprised to have the past tense applied to him! Still alive and kicking; had lunch with him earlier this year. Good guy.

I'm sure Bill Dement, (William C. Dement, MD, Ph.D.), famous sleep researcher (trained as a psychiatrist with PhD in neurophysiology) would be surprised to have the past tense applied to him! Still alive and kicking; had lunch with him earlier this year. Good guy.

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I'm glad he's still alive! I saw a sleep research video of him decades ago and in my memory it looks like it had been filmed in about 1912 so I thought he'd be about 150 now. Maybe we had a bad copy! We thought he was great, though. You're lucky to know him!

I saw dr peterson saying he had seen many patients who had become ill with me/cfids following dental surgery. infections became systemic and patients were ill for many years. this may shed some light as to why a dentist could have been invited to join the panel. german study showed a possible route to transmit xmrv via nasel and sputum so perhaps this is an arean we should be looking at.

what i was trying to ask earlier was WHEN exactly this panel shake up happened. does no one know? i'm asking because at the meeting with the NIH on Sept 7th, patient advocate charlotte made a very strong and good case for how absurd the make up of this panel was (dentists?). so i wonder if the change happened due to her Sept 7th face-to-face explanation of how important this panel is and how much we needed it to change. go, charlotte!!!!

as i have said to bob and charlotte, my co-organizers on the "Time for Action NIH 'What have you done for ME/CFS today?'" campaign, my feeling is that these ongoing meetings should have been requested in exchange for ending the Time for Action campaign. as in, we'll stop inundating you with daily emails/calls/faxes in exchange for monthly meetings where we discuss the NIH's progress on ME/CFS issues. unfortunately, we did not request this at the time. but my feeling is that now is just as a good a time as any to request it.

at these envisioned monthly (or every other month) meetings, the patient community could let NIH officials know what is (and what is not) important to change (in their sphere of influence, of course), and what changes should take priority. and at regular meetings the patient committee could serve as a type of watch dog group, helping to guide the NIH when we see them going off track (for example, we could have told them that adding dentists to a cfs grants review panel was not the best idea). at these meetings, we'd tell them our grievances and then our suggested remedies. they'd tell us what they will do in response to our grievances and suggested remedies. and at subsequent meetings, we'd get an update on their progress. with these meetings, they'd essentially be held more accountable for implementing what they *say* they will do. and knowing that they have a pending meeting in 1-2 months time, where they will have to report back to the patients, will keep a fire lit under their butt, so they feel a healthy sort of pressure to do their work and not slack off. after all, our lives are on the line. and at regular meetings we would gently remind them of this fact when they see our faces or hear our voices (phone conference calls).

though it was wonderful that mangan meet with patients spontaneously at CFSAC, i do not think that having a spontaneous meeting serves the same purpose or would get the same results as ongoing meetings with a patient group. similarly, i don't think that having 1 or 2 patients, however smart and well-meaning they are, being informally (and back channel-y) in touch with 1 or 2 NIH reps would get the same results as ongoing meetings with an established, diverse patient committee. of course, there is a role for and a usefulness of this type of arrangement, too. but it does not serve the same purpose as, or take the place of, the larger patient committee meetings. also, there is always the concern that this type of informal, backchannel arrangement would lead to the NIH's coopting of just 1-2 patients. (i am not saying that this has happened, just that it can easily happen. of course a whole patient committee can be coopted, too!)

I saw dr peterson saying he had seen many patients who had become ill with me/cfids following dental surgery. infections became systemic and patients were ill for many years. this may shed some light as to why a dentist could have been invited to join the panel. german study showed a possible route to transmit xmrv via nasel and sputum so perhaps this is an arean we should be looking at.

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Wow, I've never heard that before. How interesting. My health started to deteriorate around the time of a "botched" gum graft surgery.

what i was trying to ask earlier was WHEN exactly this panel shake up happened. does no one know? i'm asking because at the meeting with the NIH on Sept 7th, patient advocate charlotte made a very strong and good case for how absurd the make up of this panel was (dentists?). so i wonder if the change happened due to her Sept 7th face-to-face explanation of how important this panel is and how much we needed it to change. go, charlotte!!!!

as i have said to bob and charlotte, my co-organizers on the "Time for Action NIH 'What have you done for ME/CFS today?'" campaign, my feeling is that these ongoing meetings should have been requested in exchange for ending the Time for Action campaign. as in, we'll stop inundating you with daily emails/calls/faxes in exchange for monthly meetings where we discuss the NIH's progress on ME/CFS issues. unfortunately, we did not request this at the time. but my feeling is that now is just as a good a time as any to request it.

at these envisioned monthly (or every other month) meetings, the patient community could let NIH officials know what is (and what is not) important to change (in their sphere of influence, of course), and what changes should take priority. and at regular meetings the patient committee could serve as a type of watch dog group, helping to guide the NIH when we see them going off track (for example, we could have told them that adding dentists to a cfs grants review panel was not the best idea). at these meetings, we'd tell them our grievances and then our suggested remedies. they'd tell us what they will do in response to our grievances and suggested remedies. and at subsequent meetings, we'd get an update on their progress. with these meetings, they'd essentially be held more accountable for implementing what they *say* they will do. and knowing that they have a pending meeting in 1-2 months time, where they will have to report back to the patients, will keep a fire lit under their butt, so they feel a healthy sort of pressure to do their work and not slack off. after all, our lives are on the line. and at regular meetings we would gently remind them of this fact when they see our faces or hear our voices (phone conference calls).

though it was wonderful that mangan meet with patients spontaneously at CFSAC, i do not think that having a spontaneous meeting serves the same purpose or would get the same results as ongoing meetings with a patient group. similarly, i don't think that having 1 or 2 patients, however smart and well-meaning they are, being informally (and back channel-y) in touch with 1 or 2 NIH reps would get the same results as ongoing meetings with an established, diverse patient committee. of course, there is a role for and a usefulness of this type of arrangement, too. but it does not serve the same purpose as, or take the place of, the larger patient committee meetings. also, there is always the concern that this type of informal, backchannel arrangement would lead to the NIH's coopting of just 1-2 patients. (i am not saying that this has happened, just that it can easily happen. of course a whole patient committee can be coopted, too!)

these are my thoughts.

i see only gains from such ongoing meetings. no down side.

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YES! YES! YES! One standing agenda item should be a review of grant application status submitted, in review, rejected - and WHY.! We need to be able to keep score so we can refute reports about lack of requests, etc. The website should have all the details. We need total transparency on this topic.

what i was trying to ask earlier was WHEN exactly this panel shake up happened. does no one know? i'm asking because at the meeting with the NIH on Sept 7th, patient advocate charlotte made a very strong and good case for how absurd the make up of this panel was (dentists?). so i wonder if the change happened due to her Sept 7th face-to-face explanation of how important this panel is and how much we needed it to change. go, charlotte!!!!

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I'm sure everybody played a part. The CFS SEP has been under rather constant discussion for several years. Reports have been made and sent to the director. The director has actually appeared several times at the CFSAC meeting and has noted the problems. Dr. Glazer noted that he'd had a long discussion with the director about it. I know the IACFS/ME and CFIDS Ass. have had several direct meetings with them. Pat Fero did a report on it I believe. I've done blogs on it......I imagine its an accumulation of things - a new overseer of the panel, ME/CFS's new visibility due to XMRV....finally the stars aligned for some reason.

YES! YES! YES! One standing agenda item should be a review of grant application status submitted, in review, rejected - and WHY.! We need to be able to keep score so we can refute reports about lack of requests, etc. The website should have all the details. We need total transparency on this topic.

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They are very touchy about details. It may take FOIA's -which in all honesty, take about 15 minutes to do. I asked that the CFSAC panel require the NIH representative to provide a summary of all activity on CFS; include number of grants applied for and accepted for and that was not acted on.

My FOIA indicated that the # of grant requests actually is VERY low; 58 over something like 6 years; 24 of which, as I remember, were for the RFA. Getting researchers interested in this disorder has been one of the key problems. Hopefully that is changing with XMRV and the makeup of this panel should give them more confidence that they can get funded.

Its like a chicken and egg scenario; its been thought that they believe they can't get funded - so they don't apply. Was that true? We'll now see if the CFS SEP itself was a major drag on the number of grant applications accepted!

I'm sure Bill Dement, (William C. Dement, MD, Ph.D.), famous sleep researcher (trained as a psychiatrist with PhD in neurophysiology) would be surprised to have the past tense applied to him! Still alive and kicking; had lunch with him earlier this year. Good guy.

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Speaking of small corrections regarding names and spellings. The Scientific Review Administrator for the Center for Scientific Review is Lynn E. Luethke.

I saw dr peterson saying he had seen many patients who had become ill with me/cfids following dental surgery. infections became systemic and patients were ill for many years. this may shed some light as to why a dentist could have been invited to join the panel. german study showed a possible route to transmit xmrv via nasel and sputum so perhaps this is an arean we should be looking at.

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People, he's not a dentist!

He's a psychologist and he knows nothing about infectious agents and infection!

They are very touchy about details. It may take FOIA's -which in all honesty, take about 15 minutes to do. I asked that the CFSAC panel require the NIH representative to provide a summary of all activity on CFS; include number of grants applied for and accepted for and that was not acted on.

My FOIA indicated that the # of grant requests actually is VERY low; 58 over something like 6 years; 24 of which, as I remember, were for the RFA. Getting researchers interested in this disorder has been one of the key problems. Hopefully that is changing with XMRV and the makeup of this panel should give them more confidence that they can get funded.

Its like a chicken and egg scenario; its been thought that they believe they can't get funded - so they don't apply. Was that true? We'll now see if the CFS SEP itself was a major drag on the number of grant applications accepted!

I agree that we need to be vigilant and track this more carefully. I think I'll file a FOIA today!

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Really a thorough summary of the CFS SEP's and Trans-NIH working group's activities every year should be posted on the CFSAC site. It should include how many grants were submitted, how many were turned down, how many went up to the Working Group and how many they funded. How can the committee know what to work on if they don't know where the problems are?

Thank you Charlotte and Bob for the hopeful news. I don't understand why the CAA was silent about this.

This committee was mandated in an Act of Congress signed into law by President Clinton very early in his presidency.

"Section 447 (b) Extramarital Study Section- Not later than six months after the date of enactment of this Act, the Secretary of Health and Human Services shall establish an extramural study section for chronic fatigue syndrome research."

It was one of the CAA's biggest mistakes ever to settle for a Special Emphasis Panel instead of the intended regular Standing Study Section that I and others had been lobbying for over the course of years. Joan Sutherland put a lot of effort into it. We had the language in the bill before the CAA took over advocacy.